Who should pay for resident education?

Abstract 

House staff stipends and other costs related to maintaining a residency are listed on hospital budgets as "education." This has become a tempting target for hospital administrators and third-party payors, who ask, "Should the patient pay for medical education?" We have studied the workload of house officers on a typical pediatric surgical service in a children's hospital. General surgical residents spend 56.3 hours per week in patient care. This does not count "lag" time or "on call" time, but work that someone else--either a physician, technician, or nurse practitioner would do if there was no residency. This study, as well as others, clearly indicates that residents provide an enormous amount of patient care. It is perfectly justified to include the costs of house officers in the hospital budget. (J Pediatr Surg 1984 Dec;19(6):806-9)